2型糖尿病患者昼夜休息-活动节律与心血管疾病及死亡率的关联
Association of circadian rest-activity rhythms with cardiovascular disease and mortality in type 2 diabetes.
作者信息
Yang Lulu, Feng Hongliang, Chen Jie, Kwok Wing Yun, Benedict Christian, Tan Xiao, Zhang Jihui
机构信息
Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
出版信息
Diabetes Res Clin Pract. 2023 Mar;197:110262. doi: 10.1016/j.diabres.2023.110262. Epub 2023 Jan 20.
AIMS
To examine the associations of disrupted circadian rest-activity rhythm (CRAR) with cardiovascular diseases and mortality among people with type 2 diabetes.
METHODS
A total of 3147 participants with baseline type 2 diabetes (mean age 65.21 years, 39.78% female; mean HbA1c 50.02 mmol/mol) from UK Biobank were included. The following CRAR parameters were derived from acceleration data: interdaily stability (IS), intradaily variability (IV), relative amplitude (RA), most active 10 h period onset (M10 onset), and least active 5 h period onset (L5 onset). We used Cox proportional hazards models to estimate the associations of CRAR with cardiovascular diseases and mortality, adjusting for sociodemographic, lifestyle, and health characteristics.
RESULTS
Participants in the lowest quartile of IS and RA exhibited the greatest risk of developing cardiovascular disease (IS, hazard ratio [HR] 1.40 [95% confidence interval (CI) 1.04, 1.88]; RA, HR 2.45 [95% CI 1.73, 3.49]). However, the association between delayed L5 onset and cardiovascular disease risk did not reach statistical significance. Additionally, we found that high IV and low RA were associated with all-cause and cardiovascular mortality.
CONCLUSION
Objectively determined CRAR disturbances may increase the risk of cardiovascular diseases and mortality among people with type 2 diabetes.
目的
研究2型糖尿病患者昼夜休息-活动节律紊乱（CRAR）与心血管疾病及死亡率之间的关联。
方法
纳入了英国生物银行的3147名基线2型糖尿病患者（平均年龄65.21岁，女性占39.78%；平均糖化血红蛋白50.02 mmol/mol）。以下CRAR参数由加速度数据得出：日间稳定性（IS）、日内变异性（IV）、相对振幅（RA）、最活跃10小时时段起始时间（M10起始）以及最不活跃5小时时段起始时间（L5起始）。我们使用Cox比例风险模型来估计CRAR与心血管疾病及死亡率之间的关联，并对社会人口统计学、生活方式和健康特征进行了调整。
结果
IS和RA处于最低四分位数的参与者患心血管疾病的风险最高（IS，风险比[HR] 1.40 [95%置信区间（CI）1.04, 1.88]；RA，HR 2.45 [95% CI 1.73, 3.49]）。然而，L5起始延迟与心血管疾病风险之间的关联未达到统计学显著性。此外，我们发现高IV和低RA与全因死亡率和心血管死亡率相关。
结论
客观确定的CRAR紊乱可能会增加2型糖尿病患者患心血管疾病和死亡的风险。
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